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Sludge reflects intra-amniotic inflammation with or without microorganisms

Noriko Yoneda1, Satoshi Yoneda1, Hideki Niimi2

  • 1Department of Obstetrics and Gynecology, University of Toyama, Toyama City, Japan.

American Journal of Reproductive Immunology (New York, N.Y. : 1989)
|December 28, 2017
PubMed
Abstract

Insights

Amniotic fluid sludge in preterm labor patients is linked to intra-amniotic inflammation, even without detectable microorganisms. This finding suggests sludge is an indicator of inflammation in the amniotic cavity.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Maternal-Fetal Medicine

Background:

  • Preterm labor (PTL) poses significant risks to maternal and infant health.
  • Amniotic fluid (AF) "sludge," identified via transvaginal sonography, is a sonographic finding observed in some PTL cases with intact membranes.
  • The clinical significance of AF sludge, particularly its association with intra-amniotic infection or inflammation, requires further elucidation.

Purpose of the Study:

  • To determine if amniotic fluid (AF) "sludge" in patients experiencing preterm labor (PTL) with intact membranes is associated with intra-amniotic infection or inflammation.
  • To investigate the relationship between AF sludge and the presence of microorganisms or inflammatory markers within the amniotic fluid.

Main Methods:

  • A cohort of 105 patients with PTL before 29 weeks' gestation was studied.
  • Amniotic fluid (AF) "sludge" was assessed using transvaginal sonography.
  • Microorganisms in AF were detected using a novel PCR method, and AF interleukin-8 levels and histological chorioamnionitis were evaluated.

Main Results:

  • AF "sludge" was identified in 18.1% of the PTL patients.
  • No significant difference in the rate of microbial detection in AF was observed between patients with and without sludge (31.6% vs 38.4%).
  • Patients with AF sludge showed significantly higher levels of AF interleukin-8 (P = .005) and a higher frequency of histological chorioamnionitis (P = .010).

Conclusions:

  • The presence of amniotic fluid (AF) "sludge" in preterm labor (PTL) patients with intact membranes is associated with intra-amniotic inflammation.
  • This association with inflammation persists regardless of whether microorganisms are detected in the amniotic fluid.
  • AF sludge may serve as a sonographic marker indicative of intra-amniotic inflammatory processes.
Keywords:
amniotic fluid “sludge”eukaryote-made thermostable DNA polymeraseinfectioninflammationpolymerase chain reactionpreterm labor

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